title: A greenstick osteoporotic tibial fracture while on chemotherapy in a 12-year-old girl with osteosarcoma of the knee: does a preventive role exist for agents that reduce iatrogenic bone loss and skeletal-related events?
abstract: In patients with osteosarcoma several causative factors are implicated in the occurrence of osteoporosis, such as no weight-bearing, pre- and post-surgical immobilization, and neoadjuvant and adjuvant chemotherapy. Nevertheless, osteoporotic fractures are a rare complication in young patients. We report the case of a spontaneous greenstick fracture of the distal tibia occurring during adjuvant chemotherapy in a 12-year-old Caucasian girl. Among the various drugs, the main role of methotrexate was investigated. A review of the literature is also presented along with a discussion about the role of preventive agents able to reduce the occurrence of osteopenia and/or osteoporosis following cancer treatment.
authors.forename: C
authors.initials: C
authors.lastname: Zoccali
authors.forename: G
authors.initials: G
authors.lastname: Chichierchia
authors.forename: U
authors.initials: U
authors.lastname: Prencipe
authors.forename: C
authors.initials: C
authors.lastname: Nuzzo
authors.forename: V
authors.initials: V
authors.lastname: Anelli
authors.forename: V
authors.initials: V
authors.lastname: Ferraresi
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D007717:Knee; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D010024:Osteoporosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D013978:Tibial Fractures / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate